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Background: : Detection of latent tuberculosis infection (LTBI) in children, exposed to tuberculosis (TB) infections, followed by appropriate treatment, could be instrumental in reducing TB burden. Interferon Gamma release assays (IGRA) have higher specificity than tuberculin skin tests (TST), hence are more effective option for diagnosis. Hence, the present study was aimed to diagnose the presence of latent TB in children with the help of a new Standard E TB-Feron Enzyme-Linked Immunosorbent Assay (TBF) and evaluating its efficiency as compared to TST and Quantiferon TB Gold plus (QFT Plus). Methods: Diagnosis of LTBI in participants, <18 years old, who were the close household contacts of patients with active TB was carried out employing techniques such as TST, QFT Plus, and TBF. Results: Higher positive results were obtained with IGRA assays QFT Plus and TBF than TST. The perfect agreement was observed between QFT Plus and TBF assays with a Kappa value of 0.9176 whereas TST and TBF assay showed moderate agreement with a Kappa value of 0.42365. The level of cytokines secreted as a result of stimulation by the antigens from QFT Plus tubes was lower in comparison to antigens from TBF tubes. Conclusion: Hence, TBF, which showed similar efficiency as the widely used QFT Plus, can be a useful detection technique for LTBI in children. Moreover, it could prove to be an efficient alternative to expensive IGRAs like QFT Plus.

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BACKGROUND: India has the highest tuberculosis (TB) burden, accounting for one-fifth of the global incidence and two-third of the cases in Southeast Asia with an estimated 1.9 million new cases every year. Identifying and treating latent TB infection (LTBI) can reduce the risk of development of active disease by up to 90%, thereby decreasing a major burden to the prevalence of the disease, and thus reducing potential sources in future. AIM: Early diagnosis of LTBI by tuberculin skin test (TST) and a newer interferon-gamma release assay (IGRA). MATERIALS AND METHODS: Seventy-seven clinically asymptomatic household contacts (≤18 years) of confirmed pulmonary TB patients were enrolled to compare the performance of TST and IGRA to diagnose LTBI. At baseline, all participants underwent testing for IGRA and TST. RESULTS: TST showed positivity of 22%, while IGRA demonstrated positivity of 40% in the diagnosis of latent TB. Kappa value at 95% confidence interval was 0.4753, indicates a moderate agreement between the two tests. This indicates that IGRA is a better predictor of latent TB. Maximum positive percentage was in the age group of 16-18 years in both the tests followed by 1-5 years. AIM: Early diagnosis of LTBI by tuberculin skin test (TST) and a newer interferon-gamma release assay (IGRA).

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INTRODUCTION: Biofilms are the source of persistent infections of many pathogenic microbes. They are responsible for nosocomial infection and also associated with many surgical conditions including indwelling medical devices such as ventriculoperitoneal shunt. A significant problem encountered in shunt procedures is obstruction followed by infection, with infection rate ranging from 2% to 27%, often with poor outcome. MATERIALS AND METHODS: This study was conducted in the Department of Neuromicrobiology at a tertiary neuroinstitute for 6 months from July 1 to December 31, 2014. The samples comprised cerebrospinal fluid (CSF) from suspected cases of shunt infections. Laboratory diagnosis of causative agent was established by adopting standard procedures. Then, isolates were evaluated for production of biofilm by tissue culture plate (TCP) method and tube method. RESULTS: Of the 1642 shunt CSF samples obtained from neurosurgery, 14.79% were culture positive which yielded 254 isolates. About 51.97% were Gram-negative bacilli (GNB), 46.46% were Gram-positive cocci (GPC), and 1.57% were Candida albicans. Among GNB, nonfermenters were the most common (51.52%) followed by Pseudomonas aeruginosa (15.9%). Among GPC, coagulase-negative Staphylococci were 88.13%, out of which 43.26% were methicillin-resistant. Other GPC were Enterococcus spp. (4.24%), Staphylococcus aureus (5.08%), and Streptococcus spp. (2.54%). Among all isolates, 120 were tested for biofilm production, out of which 57.5% were biofilm producers and 42.5% were nonproducers. CONCLUSIONS: TCP was the better method to detect biofilm. Most of the biofilm producers were resistant pathogens.

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BACKGROUND: The examination of the cerebrospinal fluid (CSF) for proteins, glucose, and leukocytes still remains the basic gold standard investigation for the initial diagnosis of meningitis. Early diagnosis and initiation of antibiotics within 3 h can reduce the mortality and morbidity associated with meningitis. Hence, we conducted this study to document the usefulness of urinary reagent strip for the semi-quantitative analysis of CSF chemistry and cellularity. MATERIALS AND METHODS: All clear CSF samples were subjected for two types of tests, the definitive test and the index test. CSF microscopy and biochemical values are considered as definitive. Combur-10 urinary reagent strip was used as the index test for proteins, glucose, and leukocytes. The diagnostic accuracy of each index test was calculated using different cut-off levels (leukocyte esterase positivity 1+ vs. CSF granulocytes ≥10/cumm, proteins 1+ and 2+ vs. CSF protein ≥30 mg/dl and ≥100 mg/dl, respectively, and glucose 0 vs. ≤40 mg/dl and ≤50 mg/dl). Statistical analysis was performed to derive the specificity, sensitivity, positive predictive value, negative predictive value, likelihood ratio (LR)+, LR-, and area under curve (AUC). RESULTS: The study subjects comprised 103 cases. The strip showed a high sensitivity and specificity for leukocytes ≥10 cells/cumm. The strip showed a sensitivity of 96% and a specificity of 87.1% for proteins at a cut-off ≥100 mg/dl while the strip was less specific at a cut-off of ≥30 mg/dl. With respect to glucose, the strip was highly specific (100%) and less sensitive at both the cut-off levels. The AUC for leukocytes ≥10 cells/cumm was 99.05%; for proteins ≥30 mg/dl and ≥100 mg/dl, it was 84.86% and 95.69%, respectively; and, for glucose ≤40 mg/dl and ≤50 mg/dl, it was 86.51% and 76.99%, respectively. CONCLUSION: The routinely used urinary reagent strip can be utilized for the rapid analysis of CSF. If implemented, this technique will be useful in rural areas. It would also decrease the turnaround time in centers where the facility is available.

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While tuberculosis is still the leading opportunistic infection among human immunodeficiency virus-seropositive patients, extra-pulmonary tuberculosis is more common than pulmonary tuberculosis, with lymph nodes being a common site. Axillary lymph node pathology such as tuberculosis and lymphoma rarely mimics inflammatory breast carcinoma by producing lymphatic obstruction. We report a case of axillary lymph node tuberculosis in a 40-year-old immune-compromised woman, clinically presenting as inflammatory breast carcinoma.

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BACKGROUND AND OBJECTIVE: Periodontitis is a major public health problem in India with a prevalence of 60-80%. If untreated it acts as a risk factor for systemic diseases. Data on anaerobic periodontal microflora in the Indian population is very scarce. Hence, this study was undertaken to know the nature of oral microbiota in chronic periodontitis in this region of India and also the semiquantitative study in pre- and post-treatment group and to determine antibiotic susceptibility pattern for aerobic isolates. MATERIALS AND METHODS: The present study was conducted on 60 cases. Material was collected from the subgingival pockets in patients with chronic periodontitis attending the Periodontology, Outpatient Department. Clinical samples were transported to the laboratory in fluid thioglycollate medium. Initially Gram's stain and Fontana stains were done. Aerobic, anaerobic, and microaerophilic culture were put up. Antibiotic sensitivity test was done for aerobic isolates. RESULTS: Sixty samples yielded 121 isolates of which 78.34% were polymicrobial, 11.66% were monomicrobial and oral commensals were grown in 10% cases. Out of 121 isolates 91.74% were anaerobic, 7.43% were aerobic and 0.83% were microaerophilic. Fusobacterium species was the most common isolate among anaerobes. Using "paired t-test" "P" value was significant indicating significant reduction in colony count after phase-I periodontal therapy. CONCLUSION: This study has shown that anaerobic bacteria are important cause of chronic periodontitis, along with aerobes and microaerophilic organisms. Fusobacterium spp, Bacteroides fragilis, Porphyromonas spp and Prevotella intermedia are the most common anaerobic pathogens. Bacterial culture methods are still economical and gold standard.

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OBJECTIVE: Due to the rampant use of antibiotics bacteria are acquiring resistance to penicillin group of drugs, which results in prescription failure in clinical practice. Beta-lactamase producing organisms are not only more virulent they also cause surrounding bacteria to become resistant. Hence, this study was undertaken to know the prevalence of extended spectrum beta-lactamase (ESBL) producing anaerobic bacteria in chronic periodontitis. MATERIALS AND METHODS: The present study was conducted for a period of 1 year from January to December 2010 at a tertiary care teaching hospital. Clinical samples were collected from the sub gingival pockets from cases of chronic periodontitis and transported to the laboratory in fluid thioglycollate medium. Gram's staining was performed and anaerobic culture put up. All the anaerobic bacteria isolated were tested for beta-lactamase production by Nitrocefin disc method. RESULTS: A total of 60 samples yielded 121 isolates, out of which 26% were ESBL producers. Bacteroides fragilis was the most common organism followed by Fusobacterium species. CONCLUSION: ESBL producing anaerobic bacteria exits in chronic periodontitis cases and the present study identified 26% of the isolates to be ESBL producers. Antibiotic resistance testing is essential before starting the therapy and in emergency cases drugs should be chosen to cover ESBL producers.